구강악안면 수술환자에서 술 후 오심 및 구토에 대한 프로포폴의 예방효과

윤필영,이가영,김영균,Yun, Pil-Young,Rhee, Ka-Young,Kim, Young-Kyun 대한치과마취과학회 2006 Journal of Dental Anesthesia and Pain Medicine Vol.6 No.1

Background: The aim of this study was to evaluate the preventive effect of propofol on postoperative nausea and vomiting (PONV) following general anesthesia to the patients having oral and maxillofacial surgery. Methods: In a prospective, randomized. case-controlled study. 200 patients were divided into two groups (n = 100 in each). In propofol (P) group, patients received 0.5 mg/kg of propofol intravenously at the end of anesthesia. In control (C) group, no antiemetics was given. Emetic symptoms like nausea, retching and vomiting were assessed by a blind nurse at 1 hour and at 24 hours after anesthesia respectively. Also level of sedation was checked by a blind anesthesiologist at 1 hour after anesthesia. Results: There were no significant differences in frequencies of nausea, retching and vomiting between C group and P group at 1 hour after anesthesia. However, nausea, retching and vomiting were all decreased in P group compared with C group at 24 hours after anesthesia (P < 0.05). Also there was no significant difference in level of sedation at 1 hour after anesthesia between C group and P group (P > 0.05). Conclusions: From the results, prophylactic use of subhypnotic dose of propofol could be effective for preventing PONV without change in level of sedation to the patients undergoing general anesthesia for oral and maxillofaical surgery.

치과용 국소마취 주사시 압력조절형 주사장치 사용의 효과에 대한 연구

윤필영,김영균,Yun, Pil-Young,Kim, Young-Kyun 대한치과마취과학회 2006 Journal of Dental Anesthesia and Pain Medicine Vol.6 No.2

The purpose of this study was to evaluate the difference on pain intensity and discomfort between pressure-controlled injection system and conventional syringe injection technique from the patients undergoing oral and maxillofacial surgery. In a prospective, randomized, case-controlled study, 60 patients were divided into two groups (n=30 in each). In experimental group, pressure-controlled injection system was applied. In control group, conventional syringe injection system was applied. Pain rating score (PRS) and visual analogue scale (VAS) were assessed. The average of VAS in experimental group ($16.67{\pm}15.07$) was smaller than that of control group ($25.63{\pm}22.21$), though there were no significant differences (P=0.072). In PRS, fifteen patients (50.0%) of experimental group answered that they experienced mild pain. However sixteen patients (53.3%) of control group answered that they experienced intermediate pain. From the results, pressure-controlled injection system may be an effective method to reduce pain during the dental local anesthetic procedure.

구강악안면 수술 환자의 스트레스와 관련된 요인들의 종류와 영향력의 규모

윤필영(Pil-Young Yun),김영균(Young-Kyun Kim),이창수(Chang-Su Lee),송승일(Sung-Il Song),최용근(Yong-Geun Choi) 대한구강악안면외과학회 2004 대한구강악안면외과학회지 Vol.30 No.6

Surgical process of oral and maxillofacial area as well as dental treatment are stressful situations to the patients. It is well known that serum level of stress hormones including adrenocorticotropic hormone(ACTH) and cortisol increase when the body is exposed to stress. However, there have been few studies on demographic and clinical factors related with stress. Therefore, the purpose of this study was to supply data to cope with stress more comprehensively and efficiently by analyzing the effect of factors related with stress in addition to surgical procedure. Prospective cohort study method was selected. Serum levels of ACTH and cortisol were measured by sampling bloods pre-operatively and post-operatively from 45 patients who had been operated at the Bundang Jesaeng Hospital department of oral and maxillofacial surgery. To evaluate factors associated with stress, patients were classified according to gender, age, method of payment(insurance or self), experiences of operation, kind of operations(expected operations or unexpected operations). Relative risk was calculated to assess relationships between changes of serum level of ACTH and cortisol and factors related with stress, whereas Chi-square analysis was executed to evaluate statistical significance. With regard to serum level of ACTH, relative risk was 1.3 in the group of the patients who were less than 40 years old. With regard to serum level of cortisol, relative risk was 1.8 for women compared with men, 1.4 in the group of the patients who were less than 40 years old and 1.6 in the group of the patients who had not experienced any other operations. In addition to surgical procedure, factors related with stress included gender, age, method of payments, experiences of operation and kind of operations. Therefore, we should provide comprehensive schemes to reduce stress of the patients going through oral and maxillofacial surgery.

하악골체 설면에 발생한 골모세포종

윤필영(Pil-Young Yun),정재화(Jae-Hwa Jeong),명훈(Hoon Myoung),최상철(Sang-Chul Choi),이종호(Jong-Ho Lee),정필훈(Pill-Hoon Choung),김명진(Myung-Jin Kim) 대한치과의사협회 2003 대한치과의사협회지 Vol.41 No.3

구강편평세포암종 환자에서의 혈액 점도와 혈액 변형성 변화에 대한 연구

윤필영(Pil-Young Yun),명훈(Hoon Myoung),이종호(Jong-Ho Lee),정필훈(Pill-Hoon Choung),김명진(Myung-Jin Kim) 대한구강악안면외과학회 2004 대한구강악안면외과학회지 Vol.30 No.3

Malignant tumor have hypoxic cell fraction, which makes radio-resistant and hypoxia in tumor is a result from the blood flow decrease caused by increase in blood flow resistance. Blood viscosity increase is major factor of increased blood flow resistance and it could be attributed to the decrease in blood deformability index. For the evaluation of the change of blood viscosity and blood deformability in oral squamous cell carcinoma, we perform the test of the change of those factors between the normal control group and oral squamous cell carcinoma cell patient group. Relative viscosity measured against distilled water was 5.25±0.14 for normal control group, and 5.78±0.26 for the SCC patient group and there was statistical significance between the groups. However, there was no significant difference between the groups in blood viscosity between the groups by tumor size (T1+T2 vs T3+T4). Also, there was no significant difference between the normal control group and SCC patient group in blood deformability index and between the groups by tumor size (T1+T2 vs T3+T4). Increase in blood viscosity was confirmed with this study and it can be postulated that modification blood viscosity might contribute to decrease of hypoxia fraction in oral squamous cell carcinoma, thus improve the effect of radiotherapy and it can be assumed that the main factor of blood viscosity increase is not decrease of blood deformability in oral squamous cell carcinoma.

구강암 세포주에 대한 CKD-602의 항암 효과

윤필영(Pil-Young Yun),옥용주(Yong-Ju Ok),명훈(Hoon Myoung),이종호(Jong-Ho Lee),김명진(Myung-Jin Kim) 대한구강악안면외과학회 2005 대한구강악안면외과학회지 Vol.31 No.1

Purpose: CKD-602, a newly developed water-soluble campthotecin analogue, is a anticancer agent which act as a DNA topoisomerase I inhibitor. CKD-602 is known as more potent and tolerable agent. The main purposes of this study were to measure the cytotoxic effect of CKD-602 on the oral cancer cell lines and to evaluate the apoptotic aspect of dead cells. Materials and Methods: To determine the cytotoxic effect of CKD-602 on the oral cancer cell lines in comparison with various cell lines, such as lung cancer and colon cancer cell lines, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide(MTT) assay was performed. And apoptosis was analyzed using fluorescence-activated cell sorting(FACS) system. Results: CKD-602 decreased the viability of malignant cells in a dose dependent manner and in a time dependent manner. CKD-602 showed excellent cytotoxicity to the oral cancer cell lines. Also, apoptotic portion was increased in a dose dependent manner. Conclusion: These findings indicated that CKD-602 induced apoptotic cell death in the various cell lines including oral cancer cell lines. From the results, it was suggested that CKD-602 would be a potential therapeutic agent for the oral cancer. More successive researches on the anticancer effect of CKD-602 should be performed.

치과 수술후 발생한 지각이상 환자들의 유형 및 주관적 증상에 관한 연구

김영균(Young-Kyu Kim),윤필영(Pil-Young Yun),이용인(Yong-Il Lee) 대한치과의사협회 2008 대한치과의사협회지 Vol.46 No.6

Many dental surgeries including implant surgery, orthognathic surgery etc. have possibility of neurologic injury. As neutrosensory dysfunction has no definitive treatment modality and shows slow recovery, patients have discomforts and make the legal conflicts with surgeons. The purpose of this study was to survey the types and subjective evaluation of patients with neurosensory dysfuction after dental surgery. This study included 66 patients with postoperative neurosensory dysfunction who were operated at Seoul National University Bundang Hospital from Dee 2003 to Jun 2007. Male were 28 and female were 38. Age was from 17 to 74 years old. The results of subjective evaluation of neurosensory dysfunction were as followings. 1. The sites of the altered sensation were chin, lip, tooth, tongue and so on. 2. 40.7% of the patients didn’t explain accurately about their symptoms. 29.2% of the patients expressed anesthesia and 26.2% mild discomfort. 3. The altered sensation was expressed mostly in touching, mastication and speaking. 52.3% of the patients expressed that their symptoms always existed. 4. Neuropathic pain always existed in 44.6% of the patients. 48.3% of the patients suggested that pain was triggered by touching. Neuropathic pain always existed in 41.4% of the patients. 5. Patients showed negative responses on the question that they will take operations which cause the risk of neurosensory dysfunction in the future. The objective and subjective evaluation about the altered sensation after nerve injury nerver coincide. The subjective complaint can affect the result of treatment and daily life negatively.

외상과 턱관절 장애 연관성에 관한 연구

김영균,윤필영,안민석,김재승,Kim, Young-Kyun,Yun, Pil-Young,Ahn, Min-Seok,Kim, Jae-Seun 대한악안면성형재건외과학회 2009 Maxillofacial Plastic Reconstructive Surgery Vol.31 No.5

Objective : Trauma has been a controversial issue although it has been considered to be a major factor for the temporomandibular disorder(TMD). We evaluated the relationship between macrotrauma or microtrauma and TMD. Methods : This study was performed in patients with TMD undergoing treatment at SNUBH from October 2006 to January 2007. Sixty one male patients and 166 female patients(total 227) were included and the average age was 34 years(ranging from 14 to 85 years). We investigated the possible etiologic factors, diagnosis and treatment with the review of medical records and radiography. Chronic pain, depression, somatic score(including pain item), somatic score(excluding pain item) were evaluated on the basis of diagnostic index from the Research Diagnostic Criteria on TMD. Results : Eighteen patients(7.9%) out of 227 patients suffered from TMD as a result of macrotrauma. Ninety four(41.4%) patients had microtrauma and six patients(2.6%) had both macro- and microtrauma(etiologic factor). The main symptoms included pain. joint noise and mouth opening limitation while the other symptoms were headache and tinnitus. The patients had suffered from TMD for average 41 weeks (ranging from 1 to 480 weeks). 116 patients took splint as a major treatment. As a prognosis, 19 patients(8.4%) recovered completely. 26(11.0%) had improvement and 181(80%) had persistent symptoms. 1 patient(0.4%) underwent an arthroplasty. Diagnostic index from RDC chart showed that macrotrauma was the highest score(except depression score) among the other etiologic factors. Conclusion : This study showed that macro- and microtrauma can be considered to be the major etiologic factors of TMD, which also affect the chronic, depression and somatic discomfort.

하악골 골절 환자의 치료시 상관절강 세정술의 유용성 평가

김영균(Young-Kyun Kim),윤필영(Pil-Young Yun),김지홍(Ji-Hong Kim) 대한구강악안면외과학회 2005 대한구강악안면외과학회지 Vol.31 No.6

The objective of this study is assessment of the efficacy of upper joint space arthrocentesis on prevention of TMJ injury from patient with mantibular fractures. We divided the patients into two groups, one which consist of 24 patients who are taken arthrocentesis while open reduction of mandibular fracture, the other which consist of 27 patients without arthrocentesis from Jan 1999 to Dec 2001. We measured maximum mouth opening, excursive movement range respectively one week, one month, three months later after operation. The patients were instructed to mark on 10 cm VAS for evaluation of TMJ pain during resting, mouth opening, and mastication. We evaluated the signs and symptoms of temporomandibular disorder clinically and radiographically 6 months later. The result of this study is that there is a reduction of pain and increase of range of mandibular motion in both groups but in patients with arthrocentesis there is relatively reduction of pain and increase of range of mandibular motion compared with control group. On the points of 6 months later, temporomandibular disorder occurred in 4 patients (16.7%) in group with arthrocentesis and 13 patients(47.1%) in control group. In conclusion, we think that supplemental therapy such as arthrocentesis is helpful for the recovery of jaw function and prevention of the development of temporomandibular disorder after facial trauma.

치조능확장골절단술을 이용한 임프란트 식립술의 유용성 평가

김영균(Young-Kyun Kim),윤필영(Pil-Young Yun),김범수(Bum-Soo Kim) 대한치과의사협회 2008 대한치과의사협회지 Vol.46 No.4

Purpose : Ridge expansion osteotomy (REO) has been introduced when it is necessary to expand narrow crestal ridge with simultaneous implant placement. This study has been designed to evaluate the clinical availability of REO. Materials and methods : Subjects were patients who had visited Seoul National University Bundang Hospital from July, 2003 to December, 2005 for implant placement using REO by one surgeon. Intraoperative and postoperative complication, failure of initial osseointegration and marginal bone resorption were estimated using electronic medical record and periapical radiography. Twenty? three patients, 8 males and 15 females, mean age 51, ranged 18 to 72, were treated for mean 26 months, ranged from 16 months to 46 months. Results : Mean diameter and length of implants placed at upper anterior, were 3.72㎜ and 13.32㎜ each other. Guided bone regeneration and ridge splitting were accompanied in this study. Five cases of cortical bone fracture, three cases of crestal bone loss more than 2㎜, 2 cases of gingival recession, and 2 cases of infection were noted, but there were no implants removed because of disintegration. Success rate of implant was 91.7%, even if survival rate of implant was 100%. In addition, there were no statistical significance between the success rate of REO and bone graft (p>0.05). Conclusion : Based on the results of the present study, it can be concluded that REO technique is reliable for implant placement at atrophic ridge with adequate height compared to bone graft and other osteotomies for ridge expansion, but care should be taken of esthetic such as gingival recession because of crestal bone resorption from trauma by osteotome.